Multimedia Tools and Applications

, Volume 77, Issue 7, pp 8375–8392 | Cite as

Self authenticating medical X-ray images for telemedicine applications

  • Rajitha Bakthula
  • Shivendra Shivani
  • Suneeta Agarwal


Telemedicine focuses on sharing medical images over network among doctors for better consultation. Hence medical images must be protected from unwanted modifications (intentional/unintentional) over network. Digital watermarking can be used for this purpose. ROI based watermarking hide’s ROI (Region of Interest) information in NROI (Non-Interested Regions of Interest) regions in general. Most of the existing watermarking methods used in telemedicine are block based. Main drawback of block based watermarking is exact localization of exact tampered pixels, as even if single pixel of a block is altered the whole block is detected as tampered. Thus this paper proposes a pixel based watermark technique so that alteration can be detected exactly. This method works in three phases: first, separates the ROI and NROI, second some information depending on the relative size of ROI and NROI the ROI is embedded in NROI using LSBs of ROI. Third, a tamper detection algorithm is proposed for detecting the tampered pixels exactly. Performance of proposed method when compared with state-of-art block based approaches is found to be best having 33db of PSNR value and 80% of accuracy on an average.


Watermarking Tamper localization X-ray images E-health Medical image security Telehelth 


  1. 1.
    Al-Gindy A (2010) A fragile invertible watermarking technique for the authentication of medical images. In: Proceedings of the IEEE International symposium on signal processing and information technology (ISSPIT), pp 191–195Google Scholar
  2. 2.
    Al-Qershi OM, Khoo BE (2009) Authentication and data hiding using a reversible ROI-based watermarking scheme for DICOM images. In: Proceedings of international conference on medical systems engineering (ICMSE), pp 829–834Google Scholar
  3. 3.
    Al-Qershi OM, BeeEeKhoo (2013) Two-dimensional difference expansion (2D-DE) scheme with a characteristicsbased threshold. Signal Process 93(1):154–162CrossRefGoogle Scholar
  4. 4.
    Bouslimi D, Coatrieux G, Roux C (2012) A joint encryption/watermarking system for verifying the reliability of medical images. Comput Methods Biomed 106(1):47–54CrossRefGoogle Scholar
  5. 5.
    Bouslimi D, Coatrieux G, Cozic M, Roux C (2012) A joint encryption/watermarking system for verifying the reliability of medical images. IEEE Trans Inf Technol Biomed 16(5):891–899CrossRefGoogle Scholar
  6. 6.
    Calcote S (1997) Developing a secure healthcare information network on the Internet. Healthcare Finan Manag 51(1):68Google Scholar
  7. 7.
    Cao, Lijie (2006) Singular value decomposition applied to digital image processing. Division of Computing Studies, Arizona State University Polytechnic Campus, Mesa Arizona State University Polytechnic CampusGoogle Scholar
  8. 8.
    Chiang K-H, Chang-Chien K-C, Chang R-F, Yen H-Y (2008) Tamper detection and restoring system for medical images using wavelet-based reversible data embedding. J Digit Imag 21(1):77–90CrossRefGoogle Scholar
  9. 9.
    Coatrieux G, Lamard M, Daccache W, Puentes J, Roux C (2005) A low distortion and reversible watermark: application to angiographic images of the retina. In: Proceedings of the IEEE 27th annual conference of engineering in medicine and biology, pp 2224–2227Google Scholar
  10. 10.
    Coatrieux G, Montagner J, Huang H, Roux C (2007) Mixed reversible and RONI watermarking for medical image reliability protection. In: Proceedings of the 29th international conference of the IEEE EMBS. Lyon, pp 5653–5656Google Scholar
  11. 11.
    Das S (2011) Hybrid Contourlet-DCT based robust image watermarking technique applied to medical data management. In: Proceedings of the 4th International conference on pattern recognition and machine intelligence, pp 286–292Google Scholar
  12. 12.
    Deng X, Chen Z, Zeng F, Zhang Y, Mao Y (2013) Authentication and recovery of medical diagnostic image using dual reversible digital watermarking. J Nanosci Nanotechnol 13(3):2099–2107CrossRefGoogle Scholar
  13. 13.
    Eswaraiah R, Sreenivasa Reddy E (2014) Medical image watermarking technique for accurate tamper detection in ROI and exact recovery of ROI. Int J Telemed Appl 13Google Scholar
  14. 14.
    Fontani M, De Rosa A, Caldelli R, Filippini F, Piva A, Consalvo M, Cappellini V (2010) Reversible watermarking for image integrity verification in hierarchical PACS. In: Proceedings of the of 12th ACM workshop on multimedia and security, pp 161–168Google Scholar
  15. 15.
    Gravel P, Beaudoin G, Guise JA (2004) A method for modeling noise in medical images. IEEE Trans Med Imag 23(10):1221–1232CrossRefGoogle Scholar
  16. 16.
    Guo X, Zhuang T-g (2009) A region based lossless watermarking scheme for enhancing security of medical data. J Digit Imag 22(1):53–64CrossRefGoogle Scholar
  17. 17.
    Kim K-S, Lee M-J, Lee J-W, Tae-Woo O h, Lee H-Y (2011) Region-based tampering detection and recovery using homogeneity analysis in quality-sensitive imaging. Comput Vis Image Underst 115(9):1308–1323CrossRefGoogle Scholar
  18. 18.
    Kobayashi L, Furuie S (2009) Proposal for DICOM multiframe medical image integrity and authenticity. J Digit Imag 22(1):71–83CrossRefGoogle Scholar
  19. 19.
    Kobayashi LOM, Furuie SS, Barreto PSLM (2009) Providing integriry and authenticity in DICOM images: a novel approach. IEEE Trans Inf Technol Biomed 13(4):582–589CrossRefGoogle Scholar
  20. 20.
    Kong X, Feng R (2001) Watermarking medical signals for telemedicine. IEEE Trans Inf Technol Biomed 5(3):195–201CrossRefGoogle Scholar
  21. 21.
    Kuang LQ, Zhang Y, Han X (2009) A medical image authentication system based on reversible digital watermarking. In: 2009 1st international conference information science and engineering (ICISE), pp 1047–1050Google Scholar
  22. 22.
    Lehmann, Thomas M, Abel J, Weiß C (2006) The impact of lossless image compression to radiographs. Medical Imaging. International Society for Optics and PhotonicsGoogle Scholar
  23. 23.
    Liew S-C, Zain JM (2010) Reversible medical image watermarking for tamper detection and recovery. In: 3rd IEEE international conference on computer science and information technology (ICCSIT), vol 5, pp 417–420Google Scholar
  24. 24.
    Louwerse K (1998) The electronic patient record: the management of access— Case study: Leiden University Hospital. Int J Med Inform 49(1):39–44CrossRefGoogle Scholar
  25. 25.
    Memon NA, Chaudhry A, Ahmad M, Keerio ZA (2011) Hybrid watermarking of medical images for ROI authentication and recovery. Int J Comput Math 88(10):2057–2071CrossRefGoogle Scholar
  26. 26.
    Mohanty SP, Ramakrishnan KR (1999) A dual watermarking technique for images. In: Proceedings of the 7th ACM international multimedia. ACM Press, pp 49–51Google Scholar
  27. 27.
    Mousavi SM, Naghsh A, Manaf AA (2016) A robust medical image watermarking against salt and pepper noise for brain MRI images. Multimed Tools Appl 1–30Google Scholar
  28. 28.
    Munch H, Englemann U, Schroter A, Meinzer HP (2004) The integration of medical images with the patient record and their web based distribution. J Acad Radiol 11(6):661–668CrossRefGoogle Scholar
  29. 29.
    Nambakhsh M-S, Ahmadianb A, Zaidi H (2011) A contextual based double watermarking of PET images by patient ID and ECG signal. Comput Methods Programs Biomed 104(3):418–425CrossRefGoogle Scholar
  30. 30.
    Pan W, Coatrieux G, Cuppens-Boulahia N, Cuppens F, Roux C (2010) Medical image integrity control combining digital signature and lossless watermarking. In: Garcia-Alfaro J et al (eds) Data privacy management and autonomous spontaneous security. Springer Berlin, Heidelberg, pp 153–162CrossRefGoogle Scholar
  31. 31.
    Permana, Puguh F (2012) Medical image watermarking with tamper detection and recovery using reversible watermarking with LSB modification and run length encoding (RLE) compression. In: IEEE international conference on communication, networks and satellite (ComNetSat), pp 167–171Google Scholar
  32. 32.
    Priyanka, Maheshkar S (2016) Region-based hybrid medical image watermarking for secure relemedicine applications. Multimed Tools Appl 1–31Google Scholar
  33. 33.
    Rajitha B, Srivastava M, Agarwal S (2016) Edge preserved de-noising method for medical x-ray images using wavelet packet transformation Emerging research in computing, information, communication and applications. Springer, India, pp 449–467CrossRefGoogle Scholar
  34. 34.
    Ruotsalainen (2010) Privacy security in teleradiology. Eur J Radiol 73(1):31–35CrossRefGoogle Scholar
  35. 35.
    Singh D, Shivani S, Agarwal S (2013) Quantization-based fragile watermarking using block-wise authentication and pixel-wise recovery scheme for tampered image. Int J Image Graph 13(02):1340002CrossRefGoogle Scholar
  36. 36.
    Singh S, Rathore VS, Singh R (2016) Hybrid NSCT domain multiple watermarking for medical images. Multimed Tools Appl 1–19Google Scholar
  37. 37.
    Singh AK, Dave M, Mohan A (2016) Hybrid technique for robust and imperceptible multiple watermarking using medical images. Multimed Tools Appl 75(14):8381–8401CrossRefGoogle Scholar
  38. 38.
    Tan CK, Ng JC, Xiaotian X u, Poh CL, Guan YL, Sheah K (2011) Security protection of DICOM medical images using dual-layer reversible watermarking with tamper detection capability. J Digit Imag 24(3):528–540CrossRefGoogle Scholar
  39. 39.
    Thakkar FN, Srivastava VK (2016) A blind medical image watermarking: DWT-SVD based robust and secure approach for telimedicine applications. Multimed Tools Appl 1–29Google Scholar
  40. 40.
    Viswanathan P, Venkata Krishna P (2013) A joint FED watermarking system using spatial fusion for verifying the security issues of teleradiology. IEEE J Biomed Health Inf. Early AccessGoogle Scholar
  41. 41.
    Wu, Jeffery HK, Chang R-F, Chen C-J, Wang C-L, Kuo T-H, Moon WK, Chen D-R (2008) Tamper detection and recovery for medical images using near-lossless information hiding technique. J Digit Imag 21(1):59–76CrossRefGoogle Scholar
  42. 42.
    Zain JM, Fauzi AR (2006) Medical image watermarking with tamper detection and recovery. In: 28th annual international conference of the IEEE engineering in medicine and biology society, 2006. EMBS’06, pp 3270–3273Google Scholar
  43. 43.
    Zain JM, Baldwin LP, Clarke M (2004) Reversible watermarking for authentication of DICOM images. In: Proceedings of the 26th annual international conference of the IEEE EMBS. San Francisco, pp 3237–3240Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Rajitha Bakthula
    • 1
  • Shivendra Shivani
    • 2
  • Suneeta Agarwal
    • 1
  1. 1.National Institute of Technology AllahabadAllahabadIndia
  2. 2.Thapar UniversityPatialaIndia

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